Georgia Van Leijsen

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

599 Highland Colony Pkwy Ste 110
Ridgeland, MS 39157-6075

Phone

(601) 202-5980

NPI assigned

Jun 14, 2015

Reactivated

Jun 3, 2024

Last updated

Jun 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Watchman Group Inc.

  dba Ellie Mental Health - Ridgeland, MS

  • Mental Health Counselor
  • Ridgeland, MS
  • NPI 1740904366
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1871974055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4654 HICKORY RIDGE RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115846",
            "telephone_number": "601-622-6277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 HIGHLAND COLONY PKWY STE 110",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391576075",
            "telephone_number": "601-202-5980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN LEIJSEN",
        "first_name": "GEORGIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-14",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "deactivation_date": "2024-05-20",
        "reactivation_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NM",
            "license": "AT715",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• United Medical Wellness Complex, LLC
• Laurie Elizabeth Upchurch, MA
• Uptown Dental, LLC
• Utilization Management
• Jessica Weiss Utley, PHD
• Morgan Elizabeth Van Nortwick, COTA
• Nhan Van, PHARMD
• Vancleef Personal Care Homes LLC
• Ann Beth Bailey Vanderloo, ST
• Paul D Vanlandingham, M.D.

• Mental Health Counselor in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.